Healthcare Provider Details

I. General information

NPI: 1013572197
Provider Name (Legal Business Name): RENEWED COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2019
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 BRETON RD SE STE 104
GRAND RAPIDS MI
49546-5547
US

IV. Provider business mailing address

PO BOX 252914
WEST BLOOMFIELD MI
48325-2914
US

V. Phone/Fax

Practice location:
  • Phone: 616-219-8539
  • Fax: 616-259-6936
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: WESLEY G MORGAN
Title or Position: OWNER
Credential: LPC
Phone: 616-219-8539